Is Squirting Just Peeing? A Doctor Answers Your Most Pressing Pelvic Health Questions

Impulsive yet shockingly well-prepared, Ambreia Meadows-Fernandez has a tendency to take leaps and land on her feet. She is passionate about breastfeeding, social justice and her family. A military spouse to Rico and mom to Salem, Ambrei...

Why we shouldn't overlook our pelvic health

What's the difference between "squirting" and just peeing a little? What can be done to rehab your pelvic floor after giving birth? How common is pelvic pain? Dr. Susie Gronski, physical therapist and certified pelvic rehabilitation practitioner answers all your burning questions.

Gronski isn't an M.D. or gynecologist — she describes herself as a "physiotherapist for your privates," training both women and men on how to be their own expert in treating whatever's going on "down there."

SheKnows: What don’t you do?

Susie Gronski: If you’ve got something more than muscle-based pain like smelly ejaculate, blood in your urine, weird lumps and bumps that just popped outta nowhere, fever or chills, go see an M.D. They’re the guys who do all the blood tests and scans to make sure nothing more serious is going on.

SK: What can you tell us about "squirting"?

SG: First, the name is misleading — it isn’t [an] über amount, so it isn’t super-wet like we see in porn. Authentic female ejaculate is a mixture of diluted urine and prostate-like fluid. It is created by a tiny little gland next to your urethra... when fluid comes out of the vagina during intercourse.

SK: How can you tell if its urine or prostate fluid?

SG: Other than checking the amount, you can do a smell test. If it smells like pee, it is pee. And a third option —that I don't advise unless you check with you doc first — is to test with AZO urine strips.

SK: Do you think this recent obsession with “squirting” is in anyway tied to the porn industry? Has anyone contacted you asking about it?

SG: I have only had one woman ask about it virtually, but I believe that is because some people think that a large amount of fluid is normal. I think I would have more questions if people were more comfortable asking these types of questions.

SK: I have heard you mention coital incontinence before. I know incontinence means unintentional urinating or defecating. From what we discussed, coital incontinence is often mistaken for female ejaculate. How are they different and what is it?

SG: It is likely coital incontinence if it is a large amount. There are two kinds of coital incontinence: leaking during orgasm and leaking during penetration. When it happens during orgasm, it’s associated with overactive bladder. In other words, the bladder is contracting during orgasm, which leads to incontinence.

SK: What causes urinary incontinence?

SG: Not really. It’s more that your muscle integrity changes when your estrogen levels drop. The drop in estrogen causes thin, weak pelvic floor muscles. Thinner muscles mean less control. However, you are at a substantially higher risk for coital incontinence if you have incontinence with other daily activities such as running, sneezing or laughing.

SK: Since estrogen changes are hormonal, what can be done to combat menopause-related issues?

SG: Exercise is the No. 1 way to treat a lot of these issues. Also, stress management helps a lot and hormone replacement therapy can be used for more urgent cases.

SK: So many of these issues seem so common!

SG: As I said before, these things are common, but not normal. Vaginal deliveries stretch not just the vagina but the bladder and the urethra. Everything in your body has changed and it is important to rehab theses areas. You would go to rehab if you were in an accident that limited your mobility, so why not get rehab postpartum, you know?

SK: Speaking of hormone therapy, how can we keep these issues in mind when working with transgender individuals? Does an increase in gender-affirming surgeries relate to these topics?

Yes! Definitely! After gender-affirming surgery it is particularly important to learning how to reconnect with your areas.

You will have to rehabilitate have those muscles, and those of us in my profession have the ability to teach them how to relearn and be comfortable with their bodies. I believe it is important for health care providers to address the needs of all people. I am doing what I can to help that population as best as possible.